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Experts Corner

Dentistry

Tooth Development
by Jennifer Holtzman, DDS, Executive Director, ToothWoman Network

Jennifer Holtzman, DDSA lot of growth occurs in a baby's first nine months; baby teeth emerge around the baby’s 7th month, the bottom teeth usually erupting before the top teeth. When teeth break through the gum, the gum may be sensitive, and it’s tempting to avoid cleaning the area. But as food and debris collect, the inflammation worsens, and therefore the discomfort. A thorough cleaning usually resolves the problem. By the time the baby is 2 years old, all their baby teeth should be in. The first of the permanent teeth arrive around 6 years of age. It is normal for there to be a space between the top front teeth in young children. As the teeth next to them erupt the space usually closes. At 12 years old, all the baby teeth have been replaced, and by age 13 the second molars have erupted. Wisdom teeth usually erupt between the ages of 17-21 years. Any change to the eruption sequence: trauma, extractions, dental infections, can have serious and long term effects on the health development of the child; permanent teeth may erupt late, perhaps in the wrong position. If teeth are lost prematurely, appliances can limit the harmful consequences.

During the process of eruption, the same teeth on opposite sides of the mouth may not erupt at the same time, but they will probably erupt within 6 months of each other. Teeth can also erupt in the “wrong” position; 10% of kids have teeth erupt on the tongue side of the baby teeth from an unknown cause, often the involved teeth are the ones on either side of the two front teeth on the bottom jaw.

Sometimes permanent teeth don’t develop. The teeth on either side of the front two teeth (maxillary laterals), and the teeth on the lower, right in front of the large molar teeth (mandibular second bicuspids), are the most common teeth that don’t develop. Bridges, or implants may be considered to fill in the space.

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